301 4TH AVE N.PDFlill lill lill
5032
301 4TH AVE N
0 . 0
ADDRESS: ;44e-
TAX ACCOUNT/PARCEL #: 00#,�3V2,6
BUILDING PERMIT (NEW STRUCTURE) #:
COVENANTS (RECORDED) FOR:
CRITICAL AREAS #: DETERMINATION: El Conditional Waiver Study Required E] Waiver
CRITICAL AREAS #: DETERMINATION: F-1 Conditional Waiver Study Required E] Waiver
DISCRETIONARY PERMIT #'S:
DRAINAGE PLAN DATED:
PARKING AGREEMENTS DATED:
EASEMENT(S) RECORD FOR:
PERMITS (OTHER — list permit #'s):
PLANNING DATA CHECKLIST DATED:
SCALED PLOT PLAN DATED:
SEWER LID FEE $:
LID #:
SHORT PLAT FILE:
LOT:
BLOCK:
SIDE SEWER AS BUILT DATED:
SIDE SEWER PERMIT(S) #:
GEOTECH REPORT DATED:
STREET USE/ENCROACHMENT PERMIT #:
FOR:
WATER METER TAP CARD DATED:
OTHER:
L:\TEMP\DST's\Forms\Jana's Street File Checklist 5-14-08.doc
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F,'I,- # o4t) Y, hlo r4k
Atis -9. STREET FILE
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6-90.19 44 —
City of Edmonds
Critical Areas Checklist
'Me Critical Areas Checklist contained on
this form is to be filled out by any person
preparing a Development permit
Application for the CitY Of Edmonds prior
tO his&cr submittal of a development permit
to the.city-
11c Purpose of the Checklist is to enable
City staff to determine Whether any potential
CLitical Areas areor may be present on the
mbjcct PrOPCIV-The information needed to
complete the Checklist should be isily
available fi`OM Observations of the site or
data available at City HAI (Critical Areas
inventories, maps, or soil surveys)_
An applicant, or his/her representative. Must
fill out the chocld'st, sign and date it and
submit it to the City- The city will revie
the Chcddist, ruake a precursory site visit�
and make a determination Of the subsevcnt
St' -Ps necessary to complete a development
Permit application.
With a signed copy of this form, the
applicant Should also submit a vicinity map
of the parcelwith e*nough detail that City
staff can find and identify the Subject
parcel(s). In addition, the applicant is
encouraged to include any other pertinent
information or studies in conju iction with
this Checklist to assist staff in completing
their preliminary assessment of the site.
I have completed the attached Critical Area Checklist and attest that the answers providedare
factual, to the best of my knowledge (fill out the appropriate column below).
Owner / Applicant:
Name
Tide
Sft'ect Address
7-
city. S, te, zip
Date
Phone
Si
Applicant Representative:
Narne
Title
Street Address
City, State, Zip
Signature
Phone
Date
0 0
Critical Areas Checklist' STREET FI[8
Site Information
Project Name: AXI 1,11AX Permit Number
Site Location: _3t,')J- Property Tax Account Number V_&Le)
Approximate Site Size (acres or square feet):
Have you filled out a Critical Areas Checklist for a project on this site before?
General Site Conditions
1. Hw the site been cleared or logged? Date of most recent action:
Soils / Topography
4:-- S-e,
2. In the Snohomish County Soil Survey, what is the mapped soil type(s)? / ge,,11 1,14),
3. Describe the general site topography. Check all that apply.
Flat less than 5 feet elevation change over entire site,
Rollinz slopes on site generally less than 15% (a vertical rise of 10 feet over a
horizontal distance of 66 feet.)
)MIly: slopes present on site of more than 15% and less than 301V# ( a vertical rise
of 10 feet of horizontal distance.)
Steep: gmdesof greater than 30% present on site.
Comments
Hydrology/Vegetation.
4. Site contains areas of year-round standing water. /VO
5. Site contains areas of seasonal standing water: —Approx. Depth:
6- Site is in the floodway floodplaiq_of a water course.
7. Site contains a creek or an area where water flows across the grounds. surface? /t/Oflows-
are year-round? Flows are seasonal?
8. Site is primarily: forested meadow shrubs —;mixed V
9. Obvious wetland is present on site:
10. Wetland inventory or map indicates wetland present on site: /Vo
11. Critical Areas inventory or map indicates any Critical Area on site:
4F.or,City, U se-Oni
.. ............. ..... ...
q F0 ........... . ...
... . .... .
REQUIREb..t. re d
...... . .. .... 7 7 .7.
A ot re I
red.
ritial areas stu. y: S11,
M. I .0
fi� VER
-Determination* timber. CA. , �I.q
geyiewer
Planner Oate
'Rev 3127192
09 . -1 0
USE
CITY OF EDMONDS ZONE PERMIT
NUMBER 920 1 L J.
U
Z
S
0
E
N
CONSTRUCTION PERMIT APPIL11CATION JOB
OWNER NAME/NAME OF BUSINESS ADDRESS
Z. /0/ LE NO LID NO,
LEGAL DESCRIPTION CHECKI SUBDIVIS�IDN
MAILING ADDRESS I
7-k
PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP. TESCP Apputroed 0
CITY ZIP TELEPHONE NUMBER RW Permit Required 0
'k- �iRa 0 EXISTING — REOUIRED DEDICATION Street Use Permit Req'd 0
77JF -,7 J-rO P Inspwtion Required 0
PR
Ro
NAME . OPOSEO Side.&Ik Required 13
-7-,;4,),, - 6 It .1 /r,
CITY ZIP TELEPHONE NUMBER REMARKS
STATE LICENSE NUMBER EXPIRATION DATE
Legal Description of Property - include all easements ALLOWED
1-4, 9, // 12.
Tax'Actiount
9,7 )
Parcel No.
y .0 12 6,00 1911)
NEW
RESIDENTIAL
PLUMBING
AD DITION
COMMERCIAL
MECHANICAL
ElREMODEL
APT.BLDG.
SIGN
GRADING
FENCE
REPAIR
x _FT)
DEMOLISH
WOODSTOVE
IN ERT
S
El SWIM POOL
HOT TUB/SPA
GARAGE
. 177 RETAINING WALL/
CARPORT
III ROCKERY
RENEWAL
(TYPE OF USE. BUSINESS OR ACTIVITY) EXPLAIN:
NUMBER OF STORIES
UMBER OF
DWELLING
UNITS
DESCRIBE WORK TO BE DONE (ATTACH
PLOT PLAN)
MEMO DATED
EA SEPAREVIEW
PROPOSED COMPLETE jE:X7EMPT
EXP
EVIEW BY
172S
T
SETBACKS —FEET THEIGHT LI
FRONT SIDE
ADO NO,
IORELINE N
CHECKED BY. TYPE OF ;ONSTRUCTiON CODE HEIGI
SPECI INSPECTOR JAREA OCCUPANC =CU
R OUItL
E ED GROUP LOAD
0 YES
REMAHA5
PROGRESS INSPECTIONS PER LISC 305
FINAL INSPECTION REOUIRED
PLAN CHECK FEE
BUILDING
HEAT SOURCE:
%
PLUMBING
Plan Check No.
MECHANICAL
This Permit covers work to be done on private property ONLY.
GRADINGIFILL
Any construction on the public domain (curbs, sidewelks.
STATE SURCHARVE
driveways, marquees, etc.) will require separate permission.
Permit Application: 180 Days
Permit Limit: I Year - Provided Work Is Started Within 180 Days
STORM DRAINAGE FEE
"Applicant. on behalf of his or her spouse, heirs, assigns and
ENG. INSPECTION FEE
successors in interest, agrees to indemnity, defend and hold
harmless the City of Edmonds, Washington. Its officials,
employees, and agents from any and all claims for damages of
whatever nature, arising directly or Indirectly from the Issuance
of this permit. Issuance of this permit shall not be deemed to
PLAN CHECK DEPOSIT
or
modify, waive or reduce any requirement of any city ordinance
nor limit in any way the City's ability to enforce any ordinance
provision."
TOTAL AMOUNT DUE
I hereby acknowledge that I have read this application; that the
information given is correct; and that I am the owner, or the duly ATTENTION
authorized agent of the owner. I agree to comply with city and THIS PERMIT
:late laws regulating construction; and In doing the work authoriz. AUTHORIZES
d thereby, no person will be employed in violation of the Labor ONLY THE
Code of the State of Washington relating to Workmen's Compensa- WORK NOTED
tion InsUrance. INSPECTION
SIGNA U to NER OR AGENT) DATE all NED DEPARTMENT
CITY OF
all EDMONDS
CALL FOR
AT18040N INSPECTION
IT S UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE
1' 771-0220
UNTIL A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR
M
APPLICATION APPROVAL
This application is not a permit until
signed by the Building Official or his/her
Deputy; and fees are paid, and receipt Is
acknowledged in space provided.
14
?�FICIAL�jlr`W IIAT FIE DATE
�ELEASEO BY: DATE
ORIGINAL — File YELLOW -- Inspector
PINK — Owner GOLD — Assessor
STREET. FILE
8
A CERTIFICATE OF OCCUPANCY HAS BEEN GRANTED. USC
CHAPTER 3.
XHA 7—
City of E
RIGHT-OF-WAY CONSTRUCTION
UJ
—J
LL.�
I--
UJ
W
PERMIT
Permit Number.
01 V Wue Date:
�7A. Address or Vicinity of Construction: 3()l 4 ky, N. (9316414)
8 9 0 1 . c� B. Type of Work (be specific): Install New Service
C. Contractor: Washington Nat'l. Gas Co.
Mailing Address: 815 Mercer St.Seattle,Wn.
State License #: 98111
D. Building Permit # (if applicable):
Contact: Frank Swan
Phone: 224-2278
Liability Insurance: Bond: $
Side Sewer Permit # (if applicable):
E. Commercial Subdivision El City Project XF3 Utility (PUD, GTE, WNG, CABLE, WATER)
Multi -Family Single Family E] Other
INSPECTOR: INSPECTOR:
F. Pavement or Concrete Cut: &Yes [:]No G. Size of Cut: (2) 2 x 4 Cuts H. Chargq�-$
1-Nater 1-to cross paviiig
APPLICANT TO READ N'D SIGN
INDEMNITY. Applicant understands and by his signature to this application, agre old the City ofEdmonds har 702XVes, damages, or
Sd'o'l. ;�O'
claims of any kind or description whatsoever, foreseen or unforeseen, that may Et.e against the City of Edmor departments or
employees, including or not limited to the defense of any legal proceedings including erise c s and attorney fees b5,��y�.n)of rakting this permit.
THE CONTRACTOR IS RESPONSIBLE FOR WORKMANSHIP AND MATERIALS FOR A PERIOD OF ONE YEAR -FOLLOWING THE FINAL
INSPECTION AND ACCEPTANCE OF THE WORK. ESTIMATED RESTORATION FEES WILL BE HELD UNTIL THE F�l AL.STREETPATCH
PIfkICANT.
IS COMPLETED BY CITY FORCES, AT WHICH TIME A DEBIT OR CREDIT WILL BE PR ;E�FORISSUANCF� A""
Construction drawing of proposed work required with permit application.
A 24 hour notice is required for inspection; Please call the Engineering Division, 771-0220.
Work and material is to be inspected during progress and at completion.
Restoration is to be in accordance with City Codes.
Street shall be kept clean at all times.
Traffic Control and Public Safety shall be in accordance with City regulations as required by the City Engineer.
All street cut ditches shall be patched with asphalt or City approvedi�aterial prior to the end of the w'or'king day;
NO EXCEPTIONS.
Ihaue read the above statements andunderstand thepermit requirements andthepink copyof thepermit willbe
available on site at all times for inspection-P'urp-oses-,
00009002
Signature: Date: May 20, 1993
(Contractor or Agent),,
CALL DIAL-A-DIG.PRIOR TO BEGINNING WORK
FOR CITY USE ONLY
APPROVED BY: U-
TIME AUTHORIZED VOID AFrER DAYS
SPECIAL CONDITIONS: A -
COMMENTS:
TOTAL FE E:
RECEIPT FEE:
- — A -
DATE:
ISSUED BY:
M
NO WORK SHALL BEGIN PRIOR TO PERMIT ISSUANCE
Engrg. Div. 1991
FIELD INSPECTION NOTES
I Comments:
I Diagram.:
(Fund 111 - Route copy to Street Dept.)
CONTRACTOR CALLED FOR INSPECTION El YES NO
Partial Work Inspection by P.W.:
Work Disapproved By: Date:
FINAL APPROVAL BY: Date:
0
Addendum to City of Edmonds
Right of Way
Permit Application
-Submitted by: Guyla Connors
Engineering Ai de
Washington Natural Gas
521-5248
'Soi 4 L.Q Kj
4-- --31 L�4 (4-
EED
�2
,,7
WNG to window'
Water main depth
unknown ZC�<A le; ±WC�,
2--11 gas main ;?,� 5
9- (-Z--X 4-) C-U-7S
TD C2jCES!:-::7,-
815 Macer St. (P.O. Box 1869). Seattic, WA qgI 11 (206) 622-6767
-w-
water
-9-
gas -
-ss-
sewer
-e-
water hydrant
0
water valve
I C'� tmPenlj4(k'J fuAct
-:30 Lj Ro(A k�el'v j-'.5im
-.7ix P4 rc e- I i 1 :00-
-ZO 5-Y'i 7-
L- ald
i�rpn epdo
'Secop'"d xomf,
1115jvj-, /17,4 I)e f�e_ jq
Ae
OWNER CONTRAOTOR IS-RESPOY. R
NIJ
_ER)SION CONTROL AND: lYrv2,' AGE
APPROVED
AS NOTED'
APPkOVED BY P _' NING'
-z-1
Whe�e does the csistig ate
lTdin"d
(C"`k'UL%'t"Wy)
Sce Watershed Map
Fie—B. H..]..t pit 4
S.Ppl—.t
Chapter 2.3
—
0
K_ .2t type?
oul m _wsi ba-0
Sce Deflaitions, Hadwt pg 9
FigmZIlad-tpg7
S.Ppi—t
Chapter 2.2
&
vC.'e-C
li
m
E.—pics, Had— pg 10
scllvily�-
I S, lease,
p
Secd-dist-bi,ts
Difi-i'i..,. H.d-t
Chapter 8
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— ----,-MAR -2-5
31
_9UlLD_lW_0EPA�F_MENT-
CITY OF EDMONDS
8 go - j()9
A— 0
CITY OF EDMONDS
250 - 5TH AVE. N. - EDMONDS, WA 98020 - (206) 771-0220 - FAX (206) 771-0221
COMMUNITY SERVICES DEPARTMENT
Public Works * Planning a Parks and Recreation 9 Engineering
January 6, 1992
Mr. Jeff Phillips 70/
301 4th Avenue N.
Edmonds, WA 98020
RE: CORRECTION TO PREVIOUS ADDRESS CHANGE
STREET FILE
LAURA M. HALL
MAYOR
PETER E. HAHN
DIRECTOR
5�'� 0�74�C' /j
Per our conversation of February 6, 1992 the previous address,change of
309 Edmonds Street has been changed to 315 Edmonds St. The two
2-unit apartments accessed from 4th Avenue N. will remain addressed as
303 4th Avenue N. (#1, 2, 3, and 4) and the house now addressed as 301
4th Avenue N. will remain as that address. The owner is required to
clearly post all new address signs.
Thank you for bringing it to my attention that 309 Edmonds Street was
addressed incorrectly. Sorry if it caused you any inconvenience.
The City will notify all applicable City departments of this address
chnage. It will be your responsibility to notify all others, including
the Post office. Please note the Post office guarantees delivery on
old addresses of up to one year.
In addition, please notify the City Utility Billing Department in
reference to Account #Is 109200 and 109225 to determine if billing
addresses are still correct.
Thank you,
Sharon Nolan
Permit Coordinator
cc Fire & Police
Street Files
Address Files
Public Works
Utility Billing
e Incorporoted AUgUSt I I � 1890 *
Sister Cities International — Hekinan, Japan
STF'GET FILE /-4 /z� 3 6 / 2�
CITY OF EDMONDS LARRY S. NAUGHTEN
250 - 5TH AVE. N. * EDMONDS, WA 98020 - (206) 771-3202 MAYOR
COMMUNITY SERVICES:
Public Wor!�s * Planning e Parks and Recreation 9 Engineering
890 - 199
November 26, 1991
Mr. Jeff Phillips
303 4th Avenue N.
Edmonds, WA 98020
RE: Address Change
PETER E. HAHN
DIRECTOR
I have contacted the City Building Official and the City Fire Inspector
in response to your request for addressing of the,two 2-unit apartments
on 4th Avenue North and we have all concurred that new addressing needs
to be done.
In order to make the addressing in that area consistent with the
Snohomish County addressing grid, we will need to change your present
address of 303 4th Avenue North to 301 4th Avenue North; also, the one
unit apartment to the west (on the same lot) will be 309 Edmonds
Street. The two 2-Unit apartments to the north will be 303A and 303B
4th Avenue North. The owner is responsible to clearly post new address
signs and building "All and "B" signs.
The City will notify all applicable City departments of this address
chnage. It will be your responsibility to notify all others, including
the Post Office. Please note the Post Office guarantees delivery on
old addresses of up to one year.
In addition, please notify the City Utility Billing Department in
reference to Account #Is 109200 and 109225 to determine if billing
addresses are still correct.
Thank you,
Sharon Nolan
Permit Coordinator
cc Fire & Police
Street Files
Address Files
Public Works
Utility Billing
* Incorporated August 11, 1890 0
Sister Cities International — Hekinan, Japan
6)
61
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16,
< "TIOP 61,84.
oll. CONC
BUILDING
T P
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1,84-1
C C W
T bt
LCE 611i
0.37 Tht 166.bf
SUILDING
A k..'kA %_.ALA VAN. _x NA'4' _4L 4L
RIM 60.90 w
61.80
ASPH
w
61.56
b 7
ol 10
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BUILDING 16'
3 0,8311
DW / _.*
6:1 . a4
N 60"52'2SO W 311.17-
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3ww p
1204 MEAS
CONIC- WALIK
LAN12 SURVEYORS
THIS MAP CORRECTLY REPRESENTS A SURVEY MADE: BY ME OR UNDER MY
DIRECTION IN CONFORMANCE VATH THE REQUIREMENTS OF THE SURVEY RECORDING
ACT AT THE REOUESTAOF JEFF PHILIJPS IN SEPT, 2006
I v - . � I
aofflv"
CA
L
FICA7E NO. 29539
h % 0 - - % i ZE" M"mi"OraMm F ft
LEGAL DESCRIP11ON:
LOTS 9, 10, 11, AND 12,, BLOCK J, PLAT OF CITY Or EDMONDS ACCORDING TO
THE PLAT RECORDED IN VOLUME 2 OF PLATS PAGE 39, RECORDS OF SNOHOMISH
COUNTY� WASHINGTON,
SUBJECT TO AND TOGETHER WITH ALL EASEMENTS, REMICTIONS, RESERVATIONS,
AND RIGHTS OF RECORD IF ANY.
SITUATE IN THE COUNTY OF SNOHOMISH, STATE OF WASHINGTON.
JO-EN-D
2.
HOUSE I
25'
25#
0
MONUMENTIN CASE
7..62.7
16 64.1
GAS VALVE
CONC
A % 11 __
2.4
MAIL BOX
77
120.10,
3.62
.06
04
WATER VALVE
-7 163.
IE
WATER METER
63.11
L RIM 67.02
SIGN
U71LITY POLE
BUtLOING
62.9
-d�
U TILITY POLE W/DROP
6
17
CALC
CALCULATED
DW
DRIVE WAY
62024
GRASS
r
0
QAS
ASPH
6244
Z
IE
INVERT ELEVAlnON
6444
MEAS,
MEASURED
<
P
PLATOF
PKN
s
SEWER
65.27.
SD
STORM DRAIN
w
WA7ER
A, 50, 4, W000FENCE
6%
M. I 4PI
M
DECIDUOUS OR ORNA ENTAL.EVERGREEN TREE
TRUE EXTENT OF CANOPY NOT SHOVM
GARAGE
CONIFEROUS TREE
S; TRUE EXTENT OP' CANOPY NOT SHOWN
TOP
mm A V. _�_.�xj_ of I ST.
�62.42 43_3 200.0
SPOT ELEVA'rON IS LOCATED AT THE DECIMAL POINT OF
Dw
64
0
RIM 65.19
EDM,ONDS ST.
5D SD SD
. 7\RIM 64-37
NOTE:
REFERANCE SURVEYS ON FiLE.AND CITY RIGHT -OF WAY MAPS USED FOR 47H
AVE MOTH
GENERAL NOTES
SURYM 13Y
RGG
H - ORIZONTAL DATUM: S 8957*09" E:
GMTENB 1"D SURVEYING
CNECKIM BY
ALONG THE CENTERLINE OF
BELL ST.
AppRvvw ey
A
BDMONDS, WASHINGTON
VER'11CAL DATUM: CITY OF EDMONDS
DATE PRINTED
9/24/0(
CITY SEWER INVERTS PER
SOAU
11" = 20'
7906 199TK ST SW
ROS VOL 4B PACE 84
F.13, NCL
is PG 13
MONE (425) 697-6605 FAX (425) 697-6604
ELEVATION (200.0) UNLESS AS NOTED WITH LEADER OR X
EQUIPMENT AND PROCEDURES
ALL MEASUREMENTS WERE MADE VWTH AN ELECTRONIC THEODOLITE WITH A ONE
SECOND HORIZONTAL AND VERTICAL DISPLAY AND MANUFACTURES STANDARD
POIN71140 DEMATION OF THREE SECONDS AND AN ELEGTRONIC DISTANCE
MEASUREMENT DEVIICE VATH A STANDARD DEVIATION OF 3MM:11: 3PPM
FIELD TRAVERSE METHOD IN COMPLIANCrL WITH W.A.C. M2-130-090
ALL POINTS INDICATED FOUND WERE VISITED IN 9-2005 UNLESS OTHERWISE
NOTED.
601MRI-CER ME-1-CA
FILED FOR RECORD THIS DAY OF .2006 AT
I
1h. UNDER AUDITORS FILE NUMBER AT
THE REQUEST OF R.G.GREENE
ro]
L
COUNTY AUDITOR
BY DEPUTY'AUbifCR
PLATOF SURVEY
FOR
JEFF PHILLIPS
PTN: N.W. 1/4 -S.W. 1/4� SEC. 24, T 27 N, A 3
3 NO.
2006.36
36
fl
MAR 25 .2011
DEVE . LOPMENT SERVICES
COUNTER
................